Inflammatory Bowel Disease Disability Research Articles

Disability in Inflammatory Bowel Disease: Translation to Portuguese and Validation of the “Inflammatory Bowel Disease – Disability Score”

BackgroundInflammatory bowel disease (IBD) has a physical, psychological and social impact, often compromising the patient's ability to perform daily activities. Recently a new measurement for disability in IBD was developed. The Inflammatory Bowel Disease-Disability Score (IBD-DS) comprises the following domains: mobility, self-care, major daily life activities, gastrointestinal-related problems, mental health and interaction with the environment. The aim of our study was to translate to Portuguese and to validate the IBD-DS. MethodsEighty-five patients, 55 with Crohn's disease (CD) and 30 with ulcerative colitis (UC), completed the Portuguese version of the IBD-DS and the short inflammatory bowel disease questionnaire (SIBDQ-10 questions). Disease activity was assessed using the Harvey–Bradshaw (HB) for CD and partial Mayo score (pMayo) for UC. Pearson's correlation coefficient was used to assess the correlation between the IBD-DS and SIBDQ. The Student's t-test was used to compare the mean of IBD-DS between active and inactive disease. Statistical analysis was performed with SPSS 21.0 and the statistical level of significance (α) was established at 5%. ResultsIn our study, a significant negative correlation between the IBD-DS and the SIBDQ was observed (r=−0.858, p<0.001 for CD and r=−0.933, p<0.001 for UC). There was a statistically significant difference of the mean of IBD-DS between inactive vs. active disease (93.78 vs. 117.57, p=0.016 for CD and 78.96 vs. 137.14, p<0.001 for UC). ConclusionThe Portuguese version of the inflammatory bowel disease-disability score has a strong correlation with patients’ quality of life and clinical disease activity and was shown to be a valid tool to measure disability in patients with inflammatory bowel disease.

Sa1130 Validation of a Portuguese Version of the Inflammatory Bowel Disease Disability Score

Sa1130 Validation of a Portuguese Version of the Inflammatory Bowel Disease Disability Score

P102 Validation of a Portuguese version of the Inflammatory Bowel Disease Disability Score

P102 Validation of a Portuguese version of the Inflammatory Bowel Disease Disability Score

P103 Usefulness of fluorescence spectroscopy in the diagnosis of inflammatory bowel diseases

IBD-disability score (IBD-DS) comprises the following domains: demographics, mobility, gastrointestinal-related problems, selfcare, major life activities, mental health and interaction with the environment. The aim of our study was to translate to Portuguese and establish the validity of the IBD-DS. Methods: Prospectively, Portuguese patients with Crohn’s disease (CD) and ulcerative colitis (UC) completed a Portuguese version of the IBD-DS, the short inflammatory bowel disease questionnaire (SIBDQ). Harvey Bradshaw (HB) for CD and partial Mayo score (pMayo) for UC were also filled. Statistical analysis was performed with SPSS (version 18.0) and the statistical level of significance was established at 5%. Pearson’s correlation coefficient was used to assess the correlation between the IBD-DS and SIBDQ, HB and pMayo scores. The student t-test was used to compare the mean of IBD-DS between active and inactive disease. Results: A total of 85 IBD outpatients (55 CD and 30 UC) were enrolled. There was a significant negative correlation between the IBD-DS and the SIBDQ (r = 0.858 and r = 0.933 for CD and UC, respectively). The HB for CD and the pMayo for UC presented a moderate positive correlation with the IBDDS (r = 0.460 and r = 0.585, respectively). The IBD-DS accurately distinguished between inactive vs. active disease (93.78 vs. 117.57, p = 0.016 for CD and 78.96 vs. 137.14, p < 0.001 for UC). Conclusions: Our Portuguese version of the inflammatory bowel disease disability score correlates well with the patients’ quality of life and clinical disease activity and seems a valid tool to measure disability in patients with inflammatory bowel disease.

Risk factors of work disability in patients with inflammatory bowel disease — A Dutch nationwide web-based survey: Work disability in inflammatory bowel disease

BackgroundInflammatory bowel disease (IBD) is associated with high costs to society. Few data on the impact of IBD on work disability and potential predictive factors are available. AimTo assess the prevalence of and predictive factors for work disability in Crohn's disease (CD) and ulcerative colitis (UC). MethodsA web-based questionnaire was sent out in seven university hospitals and seven general hospitals in the Netherlands. Initially, 3050 adult IBD patients were included in this prospective, nationwide cohort study, whereof 2629 patients were within the working-age (18–64years). We used the baseline questionnaire to assess the prevalence rates of work disability in CD and UC patients within working-age. Prevalence rates were compared with the Dutch background population using age- and sex-matched data obtained from Statistics Netherlands. Multivariable logistic regression analyses were performed to identify independent demographic- and disease-specific risk factors for work disability. ResultsIn CD, 18.3% of patients was fully disabled and 8.8% partially disabled, compared to 9.5% and 5.4% in UC patients (p<0.01), respectively. Compared to Dutch controls, the prevalence was significantly higher, especially in CD patients. Higher age, low education, depression, chronic back pain, joint manifestations and typical disease-related risk factors such as penetrating disease course and surgery in the past were all found to be associated with work disability. ConclusionWe report high work disability rates in a large sample of IBD patients in the Netherlands. CD patients suffer more frequently from work disability than UC patients. A combination of demographic and disease-related factors is predictive of work disability.

P121 Vitamin D deficiency in Crohn's disease Portuguese patients: prevalence and risk factors

Background: Vitamin D deficiency is highly prevalent worldwide. It is even more common in specific risk groups as adolescents and young adults, and patients with malabsorption, which are typical features of Crohn’s disease. Besides its well known role in bone health through calcium and phosphorus homeostasis regulation there is increasing evidence of antiinflammatory and anti-cancer roles in the gut. However, its prevalence has never been assessed in Portuguese patients. The aim of this single center study was to assess the prevalence and risk factors of Crohn’s disease patients in an outpatient setting. Methods: We conducted a cross-sectional study by going through the clinical records of 61 Crohn’s disease patients who had undergone a serum 25(OH)D assessment. Their average age was 36.1 years (±12) and 31 (50.8%) were female. Serum 25-hydroxyvitamin D [(25(OH)D] was determined by radioimmunoassay and levels of <30 ng/ml were considered deficient. Summer season was classed as the time period from April to October. Univariate analysis was performed using the chi-square test and the independent effect of significant variables (p < 0.05) was assessed using multivariate logistic regression analysis (Wald backward stepwise method). Results: The prevalence of 25(OH)D deficiency was 69.7% (37 patients). Mean Summer 25(OH)D levels were significantly higher than Winter ones (34.4±19.2 vs 23±20.8, p < 0.002). On univariate analysis 25(OH)D deficiency was associated with Winter season (OR = 6.24; 95%CI:1.90 20.48, p = 0.002) and no physical exercise (OR = 7.7; 95%CI=1.67 35.5, p = 0.005). There was a trend association with more than 60 months disease lenght (OR = 7.5; 95%CI:1.53 36.75, p = 0.006). On multivariate analysis Winter season and physical exercise remained significantly associated. Applying a receiver operating characteristic (ROC) analysis, the area under the curve (AUC) derived from a model including Winter season and no physical exercise was 0.84 (95%CI:0.72 0.95) for 25(OH)D deficiency in Crohn’s disease patients. Conclusions: Vitamin D deficiency was common in Crohn’s disease patients and was associated with absence of physical exercise and winter time. As serum 25(OH)D were frequently below levels assumed to maintain bone homeostasis balance and modulate inflammation, its levels must be measured on a regular basis to identify patients in need for pharmacological vitamin D supplementation in winter or all year long. P122 Validation of the International Classification of Functioning, Disability and Health score: a measure of disability in inflammatory bowel diseases R. Leong1 *, T. Huang1, Y. Ko1, V. Kariyawasam1. 1Concord Hospital Inflammatory Bowel Diseases Service, Concord Hospital Gastroenterology and Liver Services, Sydney, Australia

P122 Validation of the International Classification of Functioning, Disability and Health score: a measure of disability in inflammatory bowel diseases

P122 Validation of the International Classification of Functioning, Disability and Health score: a measure of disability in inflammatory bowel diseases

Disability in Inflammatory Bowel Disease (IBD): Developing Icf Core Sets for Patients With IBD Based on the WHO International Classification of Functioning, Disability and Health

Disability in Inflammatory Bowel Disease (IBD): Developing Icf Core Sets for Patients With IBD Based on the WHO International Classification of Functioning, Disability and Health

Work Disability in Inflammatory Bowel Disease: First Results From the COIN study

Introduction: Chronic work disability is an important medical and social consequence of inflammatory bowel disease (IBD) and is associated with a substantial economic burden to society. To date, only few data exist on factors predicting work disability. Aim: The study on ‘Costs Of IBD in the Netherlands’ (COIN) aims to assess work disability, quality of life and direct and indirect costs in a large cohort of IBD patients in the Netherlands and to determine demographic, disease and work specific factors associated with these endpoints. Here, we report the baseline characteristics of the first 942 patients enrolled in this trial. Methods: Between October 1st 2010 and December 1st 2010, a total of 15,000 patients with IBD were invited by post to participate in the COIN study, which consists of a baseline and follow up web-based questionnaire every 3 months for a total of 2 years. The baseline data includes questions on demographic, disease and work specific characteristics, and a health-related quality of life questionnaire (HRQoL). All data from questionnaires ‘returned’ until November 25th 2010 were analyzed. Descriptive statistics were used to characterize patients with Crohn's disease (CD) and Ulcerative colitis (UC). Multivariate logistic regression analyses were performed to assess the association between chronic work disability and disease characteristics. Results: A total of 942 patients were included, of which 537 (57%) CD patients (35% males, mean age 46 ±14 years) and 405 (43%) UC patients (52% males, mean age 50±13 years). Patients were included from university medical centers (n=487; 52%) and general hospitals (n=455; 48%). Twenty six percent (n=139) of CD patients were chronically disabled, compared to 17% (n=68) of UC patients (Odds ratio (OR) 0.58, 95%CI 0.42-0.80). Disabled CD and UC patients had a lower EQ-5D as compared to employed patients (0.67 ±0.24 vs. 0.87 ±0.14, p 40 years (adjusted (adj.) OR 2.02; 95%CI 1.213.36), smoking (adj. OR 1.69, 95% 1.02-2.81), disease duration (adj. OR 1.02, 95%CI 1.001-1.05) and endostomy (adj. OR 2.73, 95%CI 1.49-5.00) were independently associated with work disability. In UC patients, only age > 40 was associated with disability (adj. OR 2.20, 95%CI 1.01-4.79). Conclusion: In conclusion, almost a quarter of all IBD patients have disabling disease. This is more pronounced in CD than UC. Patients at risk for work disability are those at older age (>40 years) and with a low quality of life in both CD and UC, whereas in CD patients, also smoking, a longer disease duration and an endostomy are involved.

Disability in inflammatory bowel diseases: Developing ICF core sets for patients with inflammatory bowel diseases based on the international classification of functioning, disability, and health

The inflammatory bowel diseases (IBDs) are associated with a reduced quality of life. The impact of IBD on disability remains largely unknown. With the International Classification of Functioning, Disability, and Health (ICF) of the World Health Organization (WHO), we can now rely on a globally agreed-upon framework and system for classifying the typical spectrum of problems in the functioning of persons with a specific disease given the environmental context in which they live. The aim of this article is to outline the methods to be utilized to develop ICF Core Sets for IBD. The project is a cooperation between the ICF Research Branch of the WHO, the IPNIC group, the International Society of Physical Rehabilitation Medicine (ISPRM), and the International Organization on Inflammatory Bowel Disease (IOIBD). Four worldwide studies will be conducted from 2009 to 2010. ICF categories relevant for IBD will be identified by systematic literature review of outcomes and measures used in IBD research, semistructured patient interviews, Internet-based expert survey, and cross-sectional study for clinical applicability. The final definition of ICF Core Sets for IBD will be determined at a Consensus Conference. Field testing will then be used to validate the ICF Core Sets. ICF Core Sets are being designed to provide useful standards for research and clinical practice. This tool will enable research that improves understanding of functioning, disability, and health in IBD, and may lead to interventions to improve and maintain functioning and minimize disability among IBD patients throughout the world.